Earlier this year, I wrote about the importance of fully funding the CDC’s efforts to combat antibiotic-resistant bacteria, known as “superbugs.” But if we want to make serious gains in this problem, we need to take a holistic approach. We should change behaviors that are leading to the creation of superbugs to begin with. When your doctor advises you to finish your entire prescription, it is to prevent the proliferation of antibiotic resistant bacteria that won’t be killed by the first few doses. You have probably heard this before, and also have likely heard statistics about the over-use of prescription drugs, with reports indicating that up to half of all antibiotics prescribed today are used improperly.
What you may not have heard, however, is that the majority of drugs used in the U.S. aren’t even taken by humans. Approximately 70% of medically important antibiotics are sold for use in livestock. This is a trend that started in the middle of the 20th century when farmers began putting small doses of antibiotics in the food, water and minerals of animals for growth promotion, disease prevention, and disease control. It became standard practice and seemed to make sense – keep the animals healthy, increase growth, produce more food, increase farm profits, and lower food costs for consumers. It is even attributed with tripling American meat production over the last 50 years. But the reality hasn’t been that simple. A side effect we hadn’t anticipated was antibiotic resistance, and in turn, higher health care costs.
Fifteen years ago, the late Senator Ted Kennedy and I held hearings which highlighted early scientific evidence that antibiotic resistance could be a growing problem for human health. The scientific data was beginning to accumulate then, but today it has become crystal clear.
It is estimated that antibiotic resistance results in $20 billion in direct health care costs, and an additional $35 billion a year in lost productivity. And superbugs take a deadly toll. Just one superbug known as MRSA “kills more Americans every year than emphysema, HIV/AIDS, Parkinson’s disease, and homicide combined” according to the Infectious Diseases Society of America. So what does this have to do with the food we eat? In Flagstaff, Arizona, there’s early evidence that strains of E. Coli found in supermarket meat have led to a surge in antibiotic resistant urinary tract infections, which can spread to the bloodstream and require hospitalization.
Another study, published in the Journal of the American Medical Association (JAMA), found that proximity to swine farms or manure-fertilized agricultural fields in Pennsylvania increased an individual’s odds of contracting MRSA by 30% - 38% (depending on the strain). The theory was that the superbug strains were being spread from the pig manure, which ran into drainage systems or spread by air.
As parents, we would balk at the idea of putting daily low doses of antibiotics into our children’s meals or infant’s formula. But that is exactly what we are doing with food animals. These animals are developing “superbugs” in their guts which can be passed on to humans by handling raw meat, eating undercooked meat, and through environmental containments in the air, water and soil from farm animal fecal matter. Crops grown in proximity to food animal production or fertilized by manure can also become exposed.
This problem has increasingly received attention from medical and public health groups. A broad coalition including the American Academy of Pediatrics and the American Medical Association wrote Congressional leaders asserting that, “Overuse and misuse of important antibiotics in food animals must end, in order to protect human health.” Furthermore, the Centers for Disease Control and Prevention found that “much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe. Stopping even some of the inappropriate and unnecessary use of antibiotics in people and animals would help greatly in slowing down the spread of resistant bacteria.”
The Food and Drug Administration, which oversees drug manufacturers and determines appropriate uses for antibiotics, has taken some steps to rein in practices that could lead to antibiotic resistance. The agency issued Guidance 213, which pressures animal pharmaceutical companies to stop the labeling of drugs for growth promotion. However, many of the drugs used for growth are also indicated for disease prevention, and through this loophole these same classes of drugs will remain in agricultural use.
What can be done to change this practice that -- if left unaltered -- will weaken the effectiveness of our most important antibiotics, cost millions of healthcare dollars, and claim thousands of lives?
First, we should look to other nations that have had success in curtailing antibiotic use in livestock. Denmark has successfully addressed this problem over the past two decades by phasing out use of antibiotics for growth promotion and disease prevention in industrial pork and poultry producers. For years, low-dose antibiotics had been used to counter livestock’s increased susceptibility to illness due to being raised in smaller, more stressful environments, sometimes with inadequate diets. Denmark was able to eliminate the need for low-does antibiotics by improving animal feed, living conditions, and husbandry practices – increasing costs for producers by less than 1%.
In fact, the Economic Research Service of the U.S. Department of Agriculture suggested in its research that making similar changes in the U.S. would increase wholesale costs of pork and poultry by less than 5%, and retail prices would increase by even less. With evidence showing that a shift to drug-free meat won’t result in major changes in meat affordability, it’s a change consumers should be seeking in their grocery stores and restaurants, and demanding of their elected officials.
That leads us to the second point. The Netherlands has tried our approach of limiting antibiotic use for growth promotion, but saw no change in outcomes until they phased it out for disease prevention as well. We can learn from this experience. It’s time for the FDA to stop the sales of medically important antibiotics for both growth promotion and disease control. The agency should also take steps to measure antibiotic use in food producing animals, so we have a method to track progress to see if change is occurring or if further regulatory adjustments are needed.
Finally, we should be smart consumers. When grocery shopping, look for meats labeled USDA Certified Organic, USDA Processed Verified Never Ever 3, and Animal Welfare Approved. Companies such as Chipotle, Whole Foods and Panera Bread are responding to consumer demand by increasingly offering antibiotic-free meat, which as it turns out not only improves customer loyalty and sales – but tastes better too. And as a concerned citizen, contact your elected officials to let them know this is a priority for you and your family. Last month, Governor Jerry Brown of California signed into law legislation to curb antibiotic misuse in livestock, including banning it for disease prevention or growth – which goes beyond federal regulations.
The bottom line is, our antibiotics will lose their effectiveness over time if we do not change the way we raise our meat. We cannot risk losing major medical advancements in exchange for saving pennies on the dollar in meat prices. Our health and well-being is worth more.
